Problem-definition

Our client, a large RCM and Tech company, with a nationwide customer base across multiple specialties, brought in Quintessence as its RCM outsourcing partner.When they were reading a bid for a large opportunity, we stepped in to work with the client in the background. We helped fill out the bid documents, pre-sales capability presentations, case studies, financial case and value proposition.

Solution Partnership

Quintessence and our client set about as a team, recreating the workflows, documentation, billing edits from the last 3 years financial data and payer contracts.To cushion the impact of the switch, we agreed to set up transition guarantees for the first 6 months; and performance guarantees over the next 24 months.

Presented below is the actual data, 6 months after transition:

FY 2017 FY 2018 FY 2019
Mar to Aug Mar to Aug Mar to Aug
Charges $ 109,547,400 $ 126,527, 247 $ 130,196,537
Charges adj for Fee Sch revision $ 109,547,400 $ 120,502,140 $ 118,092,097
Collections – Insurance $ 26,181,829 $ 26,400,922 $ 28,329,349
Collections – Patient $ 3,141,819 $ 4,224,148 $ 4,249402
AR > 90 Days $ 29,323,648 $ 39,865,393 $ 34,278,513
Total Receipts $ 29,323,648 $ 30,625,070 $ 32,578,752
GCP % $ 26.768% $ 25.415% $ 27.588%
First Pass % $ 91.80% $ 91.57% $ 92.81%
Reimbursement per procedure $ 109.09 $ 108.65 $ 110.23

Results

Not only was the transition guarantees met, the partners shone with a far better performance. And we are set to meet the financial targets of FY 2020. Quintessence has also taken up physician documentation improvement assignments in a bid to further strengthen compliance and look for possible opportunities to optimize reimbursement.